{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T07:23:22Z","timestamp":1764055402834,"version":"3.45.0"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Durch den in Deutschland herrschenden demografischen Wandel verschiebt sich die Alterspyramide immer mehr nach oben. Als \u00e4lter gilt laut WHO ein Mensch zwischen dem 61. und dem 75.\u200aLebensjahr. Als alt werden Menschen ab 76 Jahren bezeichnet. F\u00fcr die Beantwortung der Frage, ob und in welchem Ausma\u00df ein alter Patient aufgrund seiner Komorbidit\u00e4ten thoraxchirurgisch operabel ist, gibt es bislang keine systematische Klassifizierung. In den meisten F\u00e4llen scheint f\u00fcr diese Entscheidung die Erfahrung und Einsch\u00e4tzung des Operateurs ausschlaggebend zu sein.<\/jats:p>\n                  <jats:p>Patienten und Methoden\u2002Die Datenanalyse erfolgte im Zeitraum von 01.\u200a2016\u201301.\u200a2018 anhand der Daten des Deutschen Thoraxregisters (Projekt-ID:2017\u201303), das unter der Schirmherrschaft der Deutschen Gesellschaft f\u00fcr An\u00e4sthesiologie und Intensivmedizin (DGAI) und der Deutschen Gesellschaft f\u00fcr Thoraxchirurgie (DGT) aufgebaut wurde. Insgesamt wurden 1357 Patienten eingeschlossen, von denen 658 ein histologisch nachgewiesenes Lungenkarzinom im Stadium I-II hatten. Diese wurden in drei Gruppen unterteilt; Gruppe I (&lt;\u200a65 Jahre), Gruppe II (65\u2013\u200a\u2264\u200a75 Jahre) und Gruppe III (&gt;\u200a75 Jahre).<\/jats:p>\n                  <jats:p>Wir konnten zeigen, dass Gruppe III, die der &gt;\u200a75-j\u00e4hrigen Patienten, im Wesentlichen keine erh\u00f6hten postoperativen Komplikationsraten hatten (Alle\u200a=\u200a48,00\u200a%; Gr. I\u200a=\u200a40,90\u200a%; Gr. II\u200a=\u200a53,00\u200a%; Gr. III\u200a=\u200a52,90\u200a%) und sogar bei einigen speziellen Komplikationen besser abschnitt, als die Gruppe der 65 bis \u2264\u200a75-j\u00e4hrigen Patienten. (z.\u200aB. postoperative Pneumonie Gruppe II\u200a=\u200a19,20\u200a%, Gruppe III\u200a=\u200a12,90\u200a%).<\/jats:p>\n                  <jats:p>Die Mortalit\u00e4t lag bei den Patienten der Gruppen I\u2013III, die in Zentren des Deutschen Thoraxregisters operiert wurden (Alle\u200a=\u200a1,70\u200a%, Gr. I\u200a=\u200a1,90\u200a%; Gr. II\u200a=\u200a1,70\u200a%; Gr. III\u200a=\u200a1,30\u200a%), insgesamt niedriger als im bundesdeutschen Durchschnitt (Alle\u200a=\u200a1,99\u200a%; Gr. I\u200a=\u200a1,23\u200a%; Gr. II\u200a=\u200a2,18\u200a%; Gr. III\u200a=\u200a3,78\u200a%). Insbesondere die alten Patienten der Gruppe III wiesen hierbei den gr\u00f6\u00dften Unterschied auf.<\/jats:p>\n                  <jats:p>Weiterhin konnten wir feststellen, dass im Gegensatz zu anderen deutschen Zentren und Kliniken, der gr\u00f6\u00dfte Teil der anatomischen Resektionen in den Zentren des Deutschen Thoraxregisters minimalinvasiv per VATS (Video-assisted Thoracoscopic Surgery) durchgef\u00fchrt wurde.<\/jats:p>\n                  <jats:p>Diskussion\u2002Auf Grundlage dieser Erhebungen stellte sich uns die Frage, ob die alten Patienten der Gruppe III (&gt;\u200a75j\u00e4hrigen) in Deutschland in der Regel einer leitliniengerechten Therapie zugef\u00fchrt wurden. Zwar gibt es eine Selektion der Patienten in Gruppe III in den Zentren des Deutschen Thoraxregisters, dennoch ist unser Appell, dass nach Abw\u00e4gung der individuellen Risiken und nach objektiven Kriterien auch diese Patientengruppe deutschlandweit der onkologischen Therapie der Wahl (Goldstandard) zugef\u00fchrt werden sollte. Hierunter verstehen wir unbedingt die anatomische Resektion mit einem minimal invasiven Zugang per VATS. Das Risiko einer postoperativen Komplikation auf Grund des Alters darf nicht die alleinige Entscheidungsgrundlage gegen eine Resektion sein.<\/jats:p>","DOI":"10.1055\/a-1549-7476","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T20:01:27Z","timestamp":1635969687000},"page":"85-91","source":"Crossref","is-referenced-by-count":0,"title":["Thoraxchirurgische Resektion des Lungenkarzinoms beim alten Menschen \u2013 bedingt der demografische Wandel ein Umdenken?"],"prefix":"10.1055","volume":"76","author":[{"given":"Klaus-Marius","family":"Bastian","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Thoraxchirurgie, Florence-Nightingale-Krankenhaus, Akademisches Lehrkrankenhaus der Heinrich-Heine-Universit\u00e4t, D\u00fcsseldorf"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aris","family":"Koryllos","sequence":"additional","affiliation":[{"name":"Lungenklinik K\u00f6ln-Merheim, Lehrstuhl f\u00fcr Thoraxchirurgie der privaten Universit\u00e4t Witten-Herdecke, Kliniken der Stadt K\u00f6ln"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Alkhatam","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Thoraxchirurgie, Florence-Nightingale-Krankenhaus, Akademisches Lehrkrankenhaus der Heinrich-Heine-Universit\u00e4t, D\u00fcsseldorf"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Schuhan","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Thoraxchirurgie, Florence-Nightingale-Krankenhaus, Akademisches Lehrkrankenhaus der Heinrich-Heine-Universit\u00e4t, D\u00fcsseldorf"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Lopez","sequence":"additional","affiliation":[{"name":"Lungenklinik K\u00f6ln-Merheim, Lehrstuhl f\u00fcr Thoraxchirurgie der privaten Universit\u00e4t Witten-Herdecke, Kliniken der Stadt K\u00f6ln"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erich","family":"Stoelben","sequence":"additional","affiliation":[{"name":"Lungenklinik K\u00f6ln-Merheim, Lehrstuhl f\u00fcr Thoraxchirurgie der privaten Universit\u00e4t Witten-Herdecke, Kliniken der Stadt K\u00f6ln"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corinna","family":"Ludwig","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Thoraxchirurgie, Florence-Nightingale-Krankenhaus, Akademisches Lehrkrankenhaus der Heinrich-Heine-Universit\u00e4t, D\u00fcsseldorf"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,11,3]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1016\/j.athoracsur.2017.06.051","article-title":"Timeliness of Care and Lung Cancer Tumor-Stage Progression: How Long Can We Wait?","volume":"104","author":"A W Maiga","year":"2017","journal-title":"Ann Thorac 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